HomeMy WebLinkAbout024-150-081NOTES
;1 -
4 RESIDENTIAL
Y-
1
'PERMIT NO. y- ---
024-150-081% 05-2048
KAWASAKI; IA'NE y
680 LARKIN RDN, GRIDLEY
Cont: GREENE & SON
REROOF35SQ
k � j
i
SPECIAL CONDITIONS
CHECKED
BY
SRA
FLOOD CERTIFICATE REQ.
FIRE SPRINKLERS REQ.
SPECIAL INSPECTION ITEMS.,
VERIFY
USE PERMIT CONDITIONS
SUB -STANDARD HOUSING LETTER
'JOB FINALED (Date)
Signature / %�—
J=OK
0 = Not OK
. = NotNot Read`yAppl
MOBILE HOMES
Date
MOBILE HOME UTILITIES (Plans) OK except #'s
1. Zoning Requirements-Setbacks-Easements
2. Soils; Special MH Support Sketch
3. Sewer, Location-Test-Fall-C/O-Concrete
4. Water, Location-Test-Easement Needed (Sketch)
S. Electricity; Location-Clearances-Gmd-/ /Amp-Concrete
6. Gas; Location-Test-Wrap;-/ ' L'ft.
/ P Nat. or/ /" L'ftJ P LPG
7. Well Clearance & Disconnect
8. Utility Clearance
Date
Card B-1 Date Card B-1
Date
Card B-1 Date Card B-1
Date
MOBILE HOME INSTALLATION (Plans) OK except #'s
1. Zoning Requirements-Setbacks-Easements
2. Footings; Size-Spacing-Marriage Line
3. Gas; MH Test-Demand-Valve-Connector
4. Electricity; MH Test-Crossovers-Breakers-Clearances
5. Drain; MH Test-Fall-Flex Connector
6. Water, MH Test-Regulator-Connectot
7. Water and Sewer Connected-C/O to Grade-HD Approval
8. Gas and Electricity Tagged
9. Tie Downs-Type-Installation Cert.
10. Exits; Insp.-Sketch
11. Cert. of Occupancy
Date
Card B-1 Date Card B-1
Date
Card B-1 Date Card B-1
Date
PERMANENT END SYSTEM (ONLY)
1. Zoning Requirements-Setbacks-Easements
2. Footings; Size-Spacing-Marriage Line
3. Blocking
4. Gas; MH Test-Demand-Valve
5. Electricity; MH Test
6. Water, MH Test
7. Water and Sewer Connected
8. Gas and Electricity Tagged
-
9. Exits
10. License Decals
_
11. Verify #'s with Office
Date
Card B-1 Date Card B-1
Date
Card B-1 Date Card B-1
MISCELLANEOUS
Date DECKS, COVERS, CARPORTS, GARAGES (Plans) OK except #'s
1. Zoning Requirements -Setbacks -Easements
2. Footings; Soils -Size -Depth -Spacing -Connectors -Steel
3. Decks, Girders and/or Joists -Decking -Bracing -Stairs -Rails
4. Wood Awn.; Posts-Beams-Rftrs-Connectors
Shthg- Frg- Bracing
5. Alum. Awn.; Columns -Connections -Splice -Decal -Enclosures
6. Carports; Windows -Doors
7. Electric
8. Frmg.; Sills-Anchors-Studs-Rftrs-Trusses
9. Siding; Nailing -Veneer -Stucco -Mesh
10. Roof; Shthg-Roofing
11. Ext.; Steps -Doors -Landings
12. Braced Wall Panels
Date Card B-1 Date Card B-1
Date Card B-1 Date Card B-1
Date POOLS (Plans) OK except #'s
1. Setbacks -Easements
2. Soils; Compaction -Structure Stability
3. Pool Structure; Steel -Connections -Thickness
Dead Men -Lining
4. Elec.; Receptacles and Lighting, Distance-GFI
5. Elec.; Pool Lighting; 15 Volts-GFI
6. Elec.; Enclosures; Conduit Entries -Terminals -Listed
7. Elec.; Bonding; Metal w/5' -Circulating Equip. -Heater
8. Elec.; Grounding; Equip. w/5' Circulating Equip. -Pool Lghtg.
Boxes-Enclosures-Panelboards-Ins. to Main Conduit
9. Health Department Approval
10. Plumb.; Cir. Test -Water Supply Test
11. Light Niche
12. Enclosure; Fencing -Alarms
Date Card B-1 Date Card B-1
Date Card B-1 Date Card B-1
J=OK
0 = Not OK
= Not Applicable
= Not Ready
RESIDENTIAL (Single & Duplex)
Date UNDERFLOOR (Plans) OK except #'s
1. Zoning -Setbacks -Easements -Flood -Slope
2. Ftg., Main; Soils-Elec. Gmd.-/ r Ftg. Depth
3. Ftg., Garage; Soils-Steel-Elec. Grnd.-/ /' Ftg. Depth
4. Ftg., Porches & Decks; Soils -Steel-/ /' Ftg. Depth
5. Stemwalls, Main; Steel-Blockouts-Wrapped
6. Stemwalls, Garage; Steel-Blockouts-Wrapped
6a. Hold Downs and Special Anchors
7. Slab, Steel -Wrapped
8. Piers -Fireplace Ftg.-Steel
9. D.W.V.; Fall -Fitting -Test -2 Way C/O -Sewer Test
10. UF, Gas Pipe; Size Anchors -Yard Gas Piping; Size Test
11. Water Pipe; Test -Anchors -Regulator -Service Test
12. Electric Underground
13. Plenums & Ducts; Clearance -Material -Support -Ins.
14. Girders -Sills -Anchor Bolts-Joists-Vents-Crippies
15. Access & Ventilation
16. Insulation
Date
Card B-1 Date Card B-1
Date
Card B-1 Date Card B-1
Date
PLUMBING (Permit) OK except #'s
17. Water Htr.; Vent -Access -Combustion Air Baffle
18. Water Pipe; Test & Anchor -Nail Protection
19. D.W.V.; Test Fittings & Anchor -Nail Protection
20. Shower Pan; Test, First Floor -Tub Access
21. Test Tub & Shower, Second Floor -Tub Access
22. Gas Pipe; Sixe & Anchors
23. Fire Sprinkler, Test
Date
Card B-1 Date Card B-1
Date
Card B-1 Date Card B-1
Date
ELECTRICAL (Permit) .OK except #'s
24. Fixture & Transformer Clearance -Ins. Protection
25. Elec. Receptacles Spacing -Lights & Switches at Doors
26. Size Boxes & No. of Conductors Stapled
27. Romex Installed Close to Edge of Studs & C.J.
28. Equip. Ground made up w/Mech Fasteners -Bond Gas & Water
29. 2 Appliance Circuits in Kitchen & Conductor Size GFI
30. Subfeed Wire Size/ /ga. Cu or AI-A.C. Wire Size/ /ga Cu or Al
31. Range Circle/ /ga Cu or AI -Oven Circ. / /ga Cu or AI
Insulated Neutral D Yes 0 No
32. Service -Riser Conductors & Ground Main Disconnect
33. Equip. Clearances Panels-Motors-Mech. Equip.
34. Clothes Closet Light -Shower Light -Spa Light
35. Smoke Detector
Date
Card B-1 Date Card B-1
Date
Card B-1 Date Card B-1
Date
MECHANICAL (Permit) OK except #'s
36. A.C. Ducts Insulation & Support
37. Vent Fan, Exhaust above insulation
38. Condensate Drain & Overflow, Size & Grade
39. Furnace -Vent Access -Comb. Ait-Return Air Vent 115 Outlet
40. Attic Access & Platform if Furnace in Attic
Date
Card B-1 Date Card B-1
Date
Card B-1 Date Card B-1
Date
FRAMING (Permit) OK except #'s
41. Sills Proper Materials & Anchors
42. Walls Studs -Nailing Spacing & Braces -Plates -Sound
43. Bearing Walls over Girders & Floor Nailing
44. Draft Stop in Walls (rat proof)
45. Fire Stops, Furred Ceilings -Stairs -Chasers -Tubs
46. Headers & Beams -Size & Bearing
Date FRAMING (Continued)
47. Hangers -Post Caps -Anchors -Connectors
48. Cling. Joist-Rftr. Ties- Purlin-Roll Brac.-Truss-Shting: Rtng.
49. Fireplace Ties or Type AFlue-Fireplace Throat Clearance
50. Attic Access; Size & Romex Protection -Draft Stop -Ins. Baffles
51. Bdnn. Windows or Exiting Doors -Sill Ht. & Dimensions
52. Garage Fire Protection Framing -RC Channel
53. Property Line Firewall & Openings
54. Ext. Doors -One 3' -Check Garage 3rd Story, 2 Exits
55. Stairs; Width -Headroom -Rise -Run -Landing -Fire Protection
56. Plywood on Roof Overhang -Attic Vents -Rafter Outriggers
57. Siding -Nailing Veneer
58. Stucco Mesh -Drip Screed -Fd. Vents-Underfir. Access
59. Glazing Area -Glass Protection -Skylights -Plastic
60. Shear Walls; Nailing -Bolts
61. Brace Interior/Exterior Wall Panels
62. Insulation -Walls -Ceilings
63. Infiltration -Walls -Windows
Date Card B-1 Date Card B-1
Date Card B-1 Date Card B-1
Date FINAL (Plans) OK except #'s
64. Ext. Steps -Door & Sidelight Protection -Landings
65. Smoke Detector
66. Furnace Vents -clearance -Comb, Air -Connector -
In Garage; Above Floor-Ducts-Mech. Protection
67. Bedroom Exiting
68. G.F.I. & Bath Fixtures & Tub Access -Spa
69. Elec. Trim & Subpanel, Breaker Sizes & Labels
70. Stairs & Rails
71. Fireplace or Stove, Clearance -Hearth
72. Elec. Outlets at Wood Panel, Int. & Ext.
73. Kit. Fixt. & Appliance; Ground -Air -Gap -Cooking Clearance
74. Elec. Outlets & Receptacles at Kit. Counter
75. Garage Fire Door, Swing -Landing -Closure
76. A.C. Duct in Garage -Damper
77. Wtr. Htr.; Vents -Clearance -Comb. Air Connector-P.R.V.
in Garage; Above Floor-Mech. Protection
78. Plb.; Elec. & Mech. Equip. Listed for Location
79. Elec. Receptacles in Garage (FFI.)-Romex Protection
80. Insulation -Foam -Looked in Attic
81. Guard Rails & Deck Construction -Post Caps
82. Fdn. VBents & Crawl Hole Door Drainage & Wood -Earth _
Clearance Looked under Floor 0 Yes
83. Following InstldJNve D Yes 0 No/Walks 0 Yes O NcOlanters O Yes O No
84. Stucco Brown -Finish
85. A.C. Unit Disconnect, Electrical -Plumbing
86. Vents Above Roof, Pibg-Appliance-Fireplace-Clearance to OpeAngs
87. Water Well, Disconnect, Electrical, Plumbing
88. Exterior Elec. Trim, G.F.I. Receptacle -Underground
89. Ventilation Throughout House
90. Glass Protection
91. Corrections from Previous Inspections
92. Gas Test -Meters Tagged, Gas -Electric
93. Water & Sewer Connected -C/O to Grade -HD Approval
94. Energy Compliance Certificate -Other Certificates
95. Address Posted
96. Fire Sprinkler
Date Card B-1 Date Card B-1
Date Card B-1 Date Card B-1
Date Card B-1 Date Card B-1
Comments at Final:
"BUTTE COUNTY
DEPARTMENT OF DEVELOPMENT SERVICES
. BUILDING PERMIT
24 HOUR INSPECTION M (530) 538-7636 (OROVILLE) (530) 891-2834 (CHICO)
OFFICE M (530) 538-7541
PERMIT NO.
BPO52048
LICENSED CONTRACTORS DECLARATION
I hereby affirm under penally of, perjury that I am licensed under
Issued Date: 08/02/2005 APN: 024-150-081-000
provisions of Chapter 9 (commencing with Section 7000) of Division 3 of
the Business and Professions Code, and my license is in full force and
Site Address'
• 680 LARKIN RD GRI
effect. � �r�-r
License Class :q License Numbers
r
Date: 9-2 D S Contractor:y$�K:2/Jr9/✓t9t7h =�
Map Index:
Description: RE ROOF COMP 35 SQ.'S
OWNER -BUILDER DECLARATION
I hereby affirm under penalty of perjury that I am. exempt from the
Contractors' State License Law for the following reason (Sec. 7031.5
Owner: KAWASAKI JANE
Business and Professions Code: Any city or county which requires a
permit to construct, alter, improve, demolish, or repair any structure, prior
.680 LARKIN RD
to its issuance, also requires the applicant for such permit to file a
GRIDLEY, CA
signed statement that he or she is licensed pursuant to the provisions of
the Contractor's State License Law (Chapter 9 commencing with Section
95948
7000) of Division 3 of the Business and Professions Code) or that he or
she is exempt therefrom and the basis for the alleged exemption. Any
violation of Section 7031.5 by any applicant for a permit subjects the
applicant to a civil penally of not more than five hundred dollars ($500).):
❑ I, as owner of the property, or my employees with wages as their
sole compensation, will do the work, and the structure is not
Applicant: KAWASAKI JANE
intended or offered for sale (Sec. 7044, Business and Professions
680 LARKIN RD
Code: The Contractors' Slate License Law does not apply to an
owner of property who builds or improves thereon, and who does
GRIDLEY, CA
such work himself or herself or through his or her own employees,
95948
provided that such improvements are not intended or offered for
sale. If however, the building or improvements are sold within one
year of completion, the owner -builder will have the burden of
proving that he or she did not build or improve for the purpose of
sale.).
❑ I, as owner of the property, am .exclusively contracting with
licensed contractors to construct the project (Sec. 7044, Business
Contractor: GREENE & SON ROOFING
and Professions Code. The Contractors' State License Law does
not apply to an owner of property who builds or improves thereon,
and who contracts for such projects with a contractor(s) licensed
PO BOX 2467
pursuant to the Contractors' State License Law.).
PARADISE, CA 95967-2467
❑ 1 am Exempt under Article 3 of the Business and Professions Code
530-873-3940
Date: Owner:
License M 275057
WORKERS' COMPENSATION DECLARATION
I hereby affirm under penalty of perjury one of the following declarations:
❑ 1 have and will maintain a certificate of consent to self -insure for
workers' compensation, as provided for by Section 3700 of the
Architect:
Labor Code, for the performance of the work for which this permit
Engineer:
is issued.
have and will maintain workers' compensation insurance, as
required by Section 3700 the Labor Code, fortheperformance of
IrI
the work for which this permit is issued. My workers' compensation
insurance carrier and policy number are:
gTsA, EvywA
Total Square Ft: 0 S. F.
Carrier:
Valuation: $0.00
3 2
Policy #:
Census Code:
❑ 1 certify that in the performance of the work for which this permit is
issued, I shall not employ any person in any manner so as to
become subject to the workers' compensation laws of California,
3 1 1'3
and agree that if I should become subject to the workers'
compensation provisions of Section 3700 of the Labor Code, I shall
forthwith complywith those provisions.
! G
t^'
xf Ind
Date:
Applicant: rT "
WARNING: Failure to secure workers' compensation coverage is
unlawful, and shall subject an employer to criminal penalties and one
hundred thousand dollars ($100,000), in addition to the cost of
,
compensation, damages as provided for in Section 3706 of the Labor
code, interest, and attorney's fees.
CONSTRUCTION LENDING AGENCY
This permit is hereby issued under the applicable provisions of the Butte County Code and/or
I hereby affirm that there is a construction lending agency for the
performance of the work for which this permit is issued (Sec 3097 Civ.)
Resolu to do work indic ted ab ve fo which fees have been paid.
t-
Name:
y:
L
RMIT EXPIRES ON: 0
Address:
at
❑ I hereby certify that the use of this facility shall comply with Sections 25505, 25533, and 25534 of the California Health and Safety Code, which regulate the storage,
' handling and use of hazardous materials.
❑ Notification in accordance with Section 19827.5 of California Health & Safety Code is not applicable to the scheduled construction of this project.
❑ Attached are copies of the required E.P.A. notification forms.
]:hereby certify that I have read this application, that the above Information is correct, and that I am the owner or the duly authorized agent of the owner. I agree to comply with
all county and stale laws relating to building construction. I acknowledge it is unlawful to alter the substance of any official fordocument of Butte County. I hereby
authorize representatives of of Butte County to enter upon the above mentioned property for inspection purposes. 7r
��
Print Name:/l Z—,f [-�'�� Signature: -
p�,
Date:
❑ Owner Contractor 0 Agent for Owner ❑ Agent.for Contractor
Z
,BUTTE COUNTY
DEPARTMENT OF DEVELOPMENT SERVICES
BUILDING PERMIT
24 HOUR INSPECTION #:' (530) 538-7636 (OROVILLE) (530) 891-2834 (CHICO)
OFFICE #: (530) 538-7541
. f
PERMIT NO.
BPO52048
,LICENSED CONTRACTORS DECLARATION
I hereby affirm,under,penaltyof: perjury that'I am licensed under
Issued Date: 08/02/2005 APN: 024-150-081-000
provisions of Chapter 9 (commencing with Section 7000) of Division 3 of
the Business and Professions Code; and my license is in full force and
�
Site Address' 680 LARKIN RD GRI
effect. �„r.r �• _ y-ry
License Class : _3 Q License Numbern�J
Map Index:
Id P
972=D�r J h
Date: Contractor: newt
Description:, RE ROOF COMP 35 SQ.'S
OWNER -BUILDER DECLARATION
I hereby affirm under penalty of perjurythat I am exempt from the
Contractors' State License Law for the following reason (Sec. 7031.5
Owner: KAWASAKI JANE
Business and Professions Code: Any city or county which requires a
permit to construct, alter, improve, demolish; or repair any siucture, prior
680 LARKIN RD
to its issuance, also requires the applicant for such permit to file a
GRIDLEY, CA
signed statement that he or she is licensed pursuant to the provisions of
the Contractor's State License Law (Chapter 9 commencing with Section
95948
7000) of Division 3 of the Business and Professions Code) or that he or
'alleged
she is exempt therefrom and the basis, for the exemption. Any
violation of Section 7031.5 by any applicant for a permit subjects the
applicant to a civil penalty of not more than five hundred dollars ($500).):
❑ I, as owner of the property, or,my employees with wages as their
sole compensation, will do the work, and the structure is not
Applicant: KAWASAKI JANE
intended or offered for sale (Sec. 7044, Business and Professions
680 LARKIN RD
Code: The Contractors' State License Law does not apply to an
•owner of property who builds or improves thereon, and who does
GRIDLEY, CA
such work himself or herself or through his or her own employees,
95948
provided that such improvements are not intended or offered for
sale. If however, the building or improvements are sold within one
year of completion, the owner -builder will have the burden of
proving that he or she did not build or improve for.the purpose of
sale.).
❑ 1, as owner of the property, am exclusively contracting with
licensed contractors to construct the project (Sec. 7044, Business
Contractor: GREENE & SON ROOFING
and Professions Code. The Contractors' State License Law does
not apply to an owner of property who builds or improves thereon,
and who contracts for such projects with a contractor(s) licensed
PO BOX 2467
pursuant to the Contractors' State License Law.).
PARADISE, CA 95967-2467
❑ 1 am Exempt under Article 3 of the Business and Professions Code
530-873-3940
Date: Owner:
License #: 275057
WORKERS' COMPENSATION DECLARATION
I hereby affirm under penalty of perjury one of the following declarations:
❑ 1 have and will maintain a certificate of consent to self -insure for
workers' compensation, as provided for by Section 3700 of the
Architect:
Labor Code, for the performance of the work for which this permit
Engineer:
is issued.
have and will maintain workers' compensation insurance, as
required by Section 3700 the Labor,Code, for the performance of
the work for which this permit is issued. My workers' compensation
rI
insurance carrier and policy number are:
,Q 97-A, a
Total Square Ft: 0 S. F.
Caer:
Valuation: $0.00
Z
Policy #: )
Census Code:
❑ 1 certify that in the performance of the work for which this permit is
issued, I shall not employ any person in any manner so as to�
become subject to the workers' compensation laws of California,
and agree that if I should become subject to the workers'
compensation provisions of Section 3'700 of the Labor Code, I shall
forthwith comply with those provisions.
Date:
Applicant: rT '
WARNING: Failure to secure workers' compensation coverage is
unlawful, and shall subject an employer to criminal penalties and one
hundred thousand dollars ($100,000), in addition to the cost of
compensation, damages as provided for in Section 3706 of the Labor
code, interest, and attorney's fees.
CONSTRUCTION LENDING AGENCY
I hereby affirm that there is a construction lending agency for the
This permit is hereby issued under the applicable provisions of the Butte County Code and/or
-to do.work InWt which fees have been paid.
performance of the work for which this permit is issued (Sec 3097 Civ.)
;esolu4
Date:
Name:
y*
RMIT EXPIRES ON:
Address:(Pato
I
❑ 1 hereby certify that the use of this facility shall comply with Sections 25505, 25533, and 25534 of the California Health and Safety Code, which regulate the storage,
handling and use of hazardous materials.
❑ Notification in accordance with Section 19827.5 of California Health & Safety Code is not applicable to the scheduled construction of this project.
❑ Attached are copies of the required E.P.A. notification forms.
I hereby certify that I have read this application, that the above information is correct, and that I am the owner or the duly authorized agent of the owner. I agree to comply with
all county and state laws relating to building construction. I acknowledge it is unlawful to alter the substance of any official form r document of Butte County. I hereby
authorize representatives of Butte County to enter upon the above mentioned property for inspection purposes.
�
Print Name: XY G—� Signature:
Date:
0 Owner Contractor 0 Agent for Owner 0 Agent for Contractor
BUTTE COUNTY
DEPARTMENT OF DEVELOPMENT SERVICES
BUILDING PERMIT APPLICATION
AND SUBMITTAL REQUIREMENTS
24 HOUR INSPECTION#: OROVILLE: (530) 538-7636 • CHICO: (530) 891-2834
OFFICE #: (530) 538-7541
A FEE WILL BE REQUIRED AT TIME OF APPLICA TION
Website: www.buttecounty.net/dds
*;-"-'PLEASE PRINT CLEARLY"
APP /CANT SIGNATURE
X
For office use only:
OWNER
Last N
Address
C Fi ame
Ks .Q_
/ psi
City
_ t
. /
Stat(Q
Zip
Phone
Zip
Fax
E-mail
Zip
APP /CANT SIGNATURE
X
For office use only:
ONTRACTOR
Name
r
Address
Q c
Address
O � � �.+,
City
Zip
`S
Stat
Zip
Phone
Q7�9 0
Fax
E mail
Name
Lic. # ,7
Cl s
APP /CANT SIGNATURE
X
For office use only:
ARCHITECT/ENGINEER
Name
Flood Zone
Address
SRA
City
No
State
Zip
Phone
Map Book
Fax
E-mail
Planner
State License Number
APP /CANT SIGNATURE
X
For office use only:
APPLICANT NAME
Name
Flood Zone
Address
SRA
City
No
State
Zip
Phone
Map Book
Fax
E-mail
Planner
APP /CANT SIGNATURE
X
For office use only:
Zoning
AN a2 LI,5t-)
Flood Zone
Propert dress
SRA
I Yes
No
Occ.
Type Const.
Subdivision Name
Map Book
Page
Lot #
Planner
Date Approved:
OVER FOR SUBMITTAL REQUIREMENTS
K:\FORMS\BUILDING FORMS\BldgApplSubRgmts.doc
PERMIT
No
-- P
BIN #
Page 1 of 2
Description or Scope of Work:
0
Sq. Footage
❑ Structure Built without Permits
❑ Proposed Change of Occupancy
(Note previous use):
EXPIRATION OF APPLICATION
Applications for which a permit has not been issued will expire one
year after the date of application. In order to renew action on an
application after expiration, a new application, plans and fee will be
REQUEST FOR REFUNDS
Refunds can only be made upon written request by the person who
paid the fee. The request must be made prior to the expiration of the
permit and no construction work has been done. Filing fees, plan
check fees for work plan checked and other department costs are not
refundable.
Received by:—e' Amount: , Bldg
SRA
Receipt #: Sheriff
SMIP
Date1' / �'` Other
�� Total
REV 2-24-05
LOCATION
AN a2 LI,5t-)
Propert dress
I
Cir�riri +
br d
Cross Street
E
`
WORKER'S COMPENSATION
Policy Number
6.9 2—
Carrier
If hiring anyone other than license contractors, a certificate of worker's
compensation must be shown at the time of permit issuance.
LENDING AGENCY
Name
Address
Page 1 of 2
Description or Scope of Work:
0
Sq. Footage
❑ Structure Built without Permits
❑ Proposed Change of Occupancy
(Note previous use):
EXPIRATION OF APPLICATION
Applications for which a permit has not been issued will expire one
year after the date of application. In order to renew action on an
application after expiration, a new application, plans and fee will be
REQUEST FOR REFUNDS
Refunds can only be made upon written request by the person who
paid the fee. The request must be made prior to the expiration of the
permit and no construction work has been done. Filing fees, plan
check fees for work plan checked and other department costs are not
refundable.
Received by:—e' Amount: , Bldg
SRA
Receipt #: Sheriff
SMIP
Date1' / �'` Other
�� Total
REV 2-24-05
Y � I
SUBMITTAL & PERMIT REQUIREMENTS
The following drawings and specifications must be submitted to the Building Division in order to apply for a
permit. INCOMPLETE SUBMITTALS WILL NOT BE ACCEPTED. ALL PLANS MUST BE LEGIBLE AND IN INK.
❑ 1. Site plans, 3 or 4 sets, signed by the preparer of the plans. No graph paper!
❑ 2. Complete plans, 3 or 4 sets, signed by the preparer of the plans (No graph paper!) OR
Engineered plans, 3 or 4 sets, with wet signature on plans AND 2 sets of stamped and signed calculations.
❑ 3. Engineered truss details and layouts in duplicate (if required). No faxes!
❑ 4. Energy compliance design and supporting documentation in duplicate.
❑ 5. Statement of Intent for Non -heated and A/C for Non -Residential Buildings.
❑ 6. Manufactured homes: (A) installation inst, (B) Marriage line info, (C) Floor Plan, (D) Tie down or fnd plans, all in
duplicate.
❑ 7. Metal bldgs: (A) Metal Bldg Plans,,(B) Fnd plans and calcs in triplicate, (C) Elevations in triplicate. (D) Floor
plans in triplicate. All of these must be stamped and wet -signed by the engineer.
❑ 8. Flood Elevation Certificate, wet -stamped and signed, in duplicate (if required).
❑ 9. Site plan and business license approval from the City of Biggs.
❑ 10. Letter of intent for non-residential buildings.
❑ 11. Detached Accessory Building Form filled out by the owner (if required).
❑ 12. Hazardous Material Form (for Commercial Buildings only).
Remaining items needed to issue the permit. Additional items may be required after Plan Check and Planning
review (May
require additional plan review upon receipt of the following items.)
❑
1.
Agricultural Buffer clearance and site plan approval from the Ag Commissioner's office (if required).
❑
2.
Impact Fees.
❑
3.
California Department of Forestry plan approval (if required).
❑
4.
NPDES Form.
❑
5.
Encroachment Permit for driveway from the Public Works Dept. (construction approval prior to occupancy).
❑
6.
Contractor's license information. (Number, Name Style, Classification).
❑
7.
Worker's Compensation Carrier and Policy Number.
❑
8.
Owner -Builder Verification (if required).
❑
9.
Letter of Signature authorization (if required).
❑
10.
Recorded copy of Agricultural Acknowledgment Statement.
❑
11.
❑ Grant Deed, ❑ M.H. Title/Statement of Facts.
❑
12.
Sanitation and site plan approval from the Environmental Health Department.
If you have questions or would like additional information regarding this process, please contact a
Permit Assistant at (530)538-7541.
EXPIRATION OF APPLICATION
Applications for which a permit has not been issued will expire one year after date of application. In order to renew action
on an application after expiration, a new application, plans and fees will be required.
REQUEST FOR FEE REFUNDS
Refunds can only be made upon written request by the person who paid the fee. The request must be made within two
years from the date of fee payment on permits not issued, and two years from the date of permit issuance for permits
issued; however, on issued permits refunds can only be made if no construction work has been done. Filing fees, plan
check fees for work plan checked and other department costs are not refundable.
OVER FOR BUILDING PERMIT APPLICATION
KAFORMS\BUILDING F0RMS\B1dgApp1SubRgmts.doc Page 2 of 2 REV 2-24-05
t NOTES
.FXx
RESIDENTIAL
( 024-150-081 03-2497
PERMIT NO. KAWASAKI, JANE
680 LARKIN RD, GRIDLEY
Cont: KEENE, ROBERT
STUCCO & DRYROT & WINDOWS M
SPECIAL CONDITIONS
CHECKED
BY
SRA
FLOOD CERTIFICATE REQ.
FIRE SPRINKLERS REQ.
SPECIAL INSPECTION ITEMS
VERIFY
USE PERMIT CONDITIONS
SUB -STANDARD HOUSING LETTER
G�
-JOB FINALED (Date)
Signature
J=OK'
0 = Not OK
. = Not Ready NotApplicable
Card B-1 Date Card B-1
MOBILE HOMES
Date
MOBILE HOME UTILITIES (Plans) OK except #'s
2.
1.
Zoning Requirements -Setbacks -Easements
Gas; MH Test -Demand -Valve -Connector
2.
Soils; Special MH Support Sketch
5.
3.
Sewer; Location -Test -Fall -C/O -Concrete
Water; MH Test -Regulator -Connector
4.
Water; Location -Test -Easement Needed (Sketch)
8.
5.
Electricity; Location-Clearances-Grnd-/ /Amp -Concrete
Tie Downs -Type -Installation Cert.
6.
Gas; Location -Test -Wrap;-/ /" L 'ft.
/ P Nat. or/ /" L "ft./ P LPG
11.
7.
Well Clearance & Disconnect
8.
Utility Clearance
Date
Card B-1 Date Card B-1
Date
Card B-1 Date Card B-1
Date MOBILE HOME INSTALLATION (Plans) OK except #'s
1.
Zoning Requirements -Setbacks -Easements _
2.
Footings; Size -Spacing -Marriage Line
3.
Gas; MH Test -Demand -Valve -Connector
4.
Electricity; MH Test -Crossovers -Breakers -Clearances
5.
Drain; MH Test -Fall -Flex Connector
6.
Water; MH Test -Regulator -Connector
7.
Water and Sewer Connected -C/O to Grade -HD Approval
8.
Gas and Electricity Tagged .
9.
Tie Downs -Type -Installation Cert.
10.
Exits; Insp.-Sketch
11.
Cert. of Occupancy
10. License Decals
11. Verify #'s with Office
Date Card B-1 Date Card B-1
Date Card B-1 Date Card.B-1
MISCELLANEOUS
Date DECKS, COVERS, CARPORTS, GARAGES (Plans) OK except #'s
1.
Date
Card B-1 Date Card B-1
Date
Card B-1 Date Card B-1
Date PERMANENT END SYSTEM (ONLY)'
1.
Zoning Requirements -Setbacks -Easements
2.
Footings; Size -Spacing -Marriage Line
3.
Blocking
4.
Gas; MH Tesf-Demand-Valve
5.
Electricity; MH Test
6.
Water; MH Test
7.
Water and Sewer Connected
8.
Gas and Electricity Tagged '
9.
Exits
10. License Decals
11. Verify #'s with Office
Date Card B-1 Date Card B-1
Date Card B-1 Date Card.B-1
MISCELLANEOUS
Date DECKS, COVERS, CARPORTS, GARAGES (Plans) OK except #'s
1.
Zoning Requirements -Setbacks -Easements
2.
Footings; Soils -Size -Depth -Spacing -Connectors -Steel
3.
Decks, Girders and/or Joists -Decking -Bracing -Stairs -Rails
4.
Wood Awn.; Posts- Beams- Rftrs-Connectors
Shthg-Frg-Bracing
5.
Alum. Awn.; Columns -Connections -Splice -Decal -Enclosures
6.
Carports; Windows -Doors
7.
Electric
8.
Frmg.; Sills-Anchors-Studs-Rftrs-Trusses
9.
Siding; Nailing -Veneer -Stucco -Mesh
10.
Roof; Shthg-Roofing
11. Ext.; Steps -Doors -Landings
12.
Braced Wall Panels
Date Card B-1 Date Card B-1
Date Card B-1 Date Card B-1
Date POOLS (Plans) OK except #'s.
1.
Setbacks -Easements
2.
Soils; Compaction -Structure Stability
3.
Pool Structure; Steel -Connections -Thickness
Dead Men -Lining
4.
Elec.; Receptacles and Lighting, Distance-GFI
5.
Elec.; Pool Lighting; 15 Volts-GFI
6. Elec.; Enclosures; Conduit Entries -Terminals -Listed
7.
Elec.; Bonding; Metal w/5' -Circulating Equip. -Heater
.8.
Elec.; Grounding; Equip. w/5' Circulating Equip. -Pool Lghtg.
Boxes- Enclosures -Panel boards- Ins. to Main Conduit
9.
Health Department Approval
10.
Plumb.; Cir. Test -Water Supply Test
11.
Light Niche
12.
Enclosure; Fencing -Alarms
Date Card B-1 Date Card B-1
Date Card'B-1- Date Card B-1
J=OK
0 = Not OK
- = Not Applicable
. = Not Ready
RESIDENTIAL (Si
Date UNDERFLOOR (Plans) OK except #'s
1.
Zoning -Setbacks -Easements -Flood -Slope
2.
Ftg., Main; Soils-Elec. Grnd.-/ /' Ftg. Depth
3.
Ftg., Garage; Soils-Steel-Elec. Grnd.-/ /" Ftg. Depth
4.
Ftg., Porches & Decks; Soils -Steel-/ /" Ftg. Depth
5.
Stemwalls, Main; Steel- Bloc kouts-Wrapped
6.
Stemwalls, Garage; Steel-Blockouts-Wrapped
6a.
Hold Downs and Special Anchors
7.
Slab, Steel -Wrapped
8.
Piers -Fireplace Ftq.-Steel
9.
D.W.V.; Fall -Fitting -Test -2 Way C/O -Sewer Test
10.
UF, Gas Pipe; Size Anchors -Yard Gas Piping; Size Test
11.
Water Pipe; Test -Anchors -Regulator -Service Test
12. Electric Underground
13. Plenums & Ducts; Clearance -Material -Support -Ins.
14. Girders -Sills -Anchor Bolts-Joists-Vents-Crippies
15.
Access & Ventilation
16.
Insulation
ngle & Duplex)
-
Date FRAMING (Continued)
47. Hangers -Post Caps -Anchors -Connector
48. Cling. Joist-Rftr. Ties- Purlin-Roll Brac.-Tru -Shting.-Rtng.
49. Fireplace Ties or Type A Flue -Fireplace Throat Clearance
50. Attic Access; Size & Romex Protection -Draft Stop -Ins. Baffles
51. Bdrm. Windows or Exiting Doors -Sill Ht. & Dimensions
52. Garage Fire Protection Framing -RC Channel
53. Property Line Firewall & Openings
54. Ext. Doors -One 3' -Check Garage 3rd Story, 2 Exits
55. Stairs; Width -Headroom -Rise -Run -Landing -Fire Protection
56. Plywood on Roof Overhang -Attic Vents -Rafter Outriggers
57. Siding -Nailing Veneer
58. Stucco Mesh -Drip Screed -Fd. Vents-Underflr. Access
59. Glazing Area -Glass Protection -Skylights -Plastic
60. Shear Walls; Nailing -Bolts
61. Brace Interior/Exterior Wall Panels
62. Insulation -Walls -Ceilings
Date
Card B-1 Date Card B-1
Date
Card B-1 Date Card B-1
Date
PLUMBING (Permit) OK except #'s
Date
17. Water Htr.; Vent -Access -Combustion Air Baffle
18. Water Pipe; Test & Anchor -Nail Protection
19. D.W.V.; Test Fittings & Anchor -Nail Protection
20. Shower Pan; Test, First Floor -Tub Access
21. Test Tub & Shower, Second Floor -Tub Access
22. Gas Pipe; Sixe & Anchors
23. Fire Sprinkler; Test
70. Stairs & Rails
Date
Card B-1 Date Card B-1
Date
Card B-1 Date Card B-1
Date
ELECTRICAL (Permit) OK except #'s
24. Fixture & Transformer Clearance -Ins. Protection
25. Elec. Receptacles Spacing -Lights & Switches at Doors
26. Size Boxes & No. of Conductors Stapled
27. Romex Installed Close to Edge of Studs & C.J.
28. Equip. Ground made up w/Mech Fasteners -Bond Gas & Water
29. 2 Appliance Circuits in Kitchen & Conductor Size GFI
30. Subfeed Wire Size/ /ga. Cu or AI-A.C. Wire Size/ /ga Cu or Al
31. Range Circle/ /ga Cu or AI -Oven Circ. / /ga Cu or Al
Insulated Neutral 0 Yes O No
32. Service -Riser Conductors & Ground Main Disconnect
33. Equip. Clearances Panels-Motors-Mech. Equip.
_
34. Clothes Closet Light -Shower Light -Spa Light
35. Smoke Detector
85. A.C. Unit Disconnect, Electrical -Plumbing
Date
Card B-1 Date Card B-1
Date
Card B-1 Date Card B-1
Date
MECHANICAL (Permit) OK except #'s
36. A.C. Ducts Insulation & Support
37. Vent Fan, Exhaust above insulation
38. Condensate Drain & Overflow, Size & Grade
39. Furnace -Vent Access -Comb. Ait-Return Air Vent 115 Outlet
40. Attic Access & Platform if Furnace in Attic
Date
Card B-1 Date Card B-1
Date
Card B-1 Date Card B-1
Date
FRAMING (Permit) OK except #'s
Date
41. Sills Proper Materials & Anchors
Date
42. Walls Studs -Nailing Spacing & Braces -Plates -Sound
Date
43. Bearing Walls over Girders & Floor Nailing
Comments at Final:
44. Draft Stop in Walls (rat proof)
45. Fire Stops, Furred Ceilings -Stairs -Chasers -Tubs
46. Headers & Beams -Size & Bearing
ngle & Duplex)
-
Date FRAMING (Continued)
47. Hangers -Post Caps -Anchors -Connector
48. Cling. Joist-Rftr. Ties- Purlin-Roll Brac.-Tru -Shting.-Rtng.
49. Fireplace Ties or Type A Flue -Fireplace Throat Clearance
50. Attic Access; Size & Romex Protection -Draft Stop -Ins. Baffles
51. Bdrm. Windows or Exiting Doors -Sill Ht. & Dimensions
52. Garage Fire Protection Framing -RC Channel
53. Property Line Firewall & Openings
54. Ext. Doors -One 3' -Check Garage 3rd Story, 2 Exits
55. Stairs; Width -Headroom -Rise -Run -Landing -Fire Protection
56. Plywood on Roof Overhang -Attic Vents -Rafter Outriggers
57. Siding -Nailing Veneer
58. Stucco Mesh -Drip Screed -Fd. Vents-Underflr. Access
59. Glazing Area -Glass Protection -Skylights -Plastic
60. Shear Walls; Nailing -Bolts
61. Brace Interior/Exterior Wall Panels
62. Insulation -Walls -Ceilings
63. I nfi Itration-Wal Is -Windows
Date
Card B-1 Date Card B-1
Date
Card B-1 Date Card B-1
Date
FINAL (Plans) OK except #'s
64. Ext. Steps -Door & Sidelight Protection -Landings
65. Smoke Detector
66. Furnace Vents -clearance -Comb, Air -Connector -
In Garage; Above Floor-Ducts-Mech. Protection
67. Bedroom Exiting
68. G.F.I. & Bath Fixtures & Tub Access -Spa
69. Elec. Trim & Subpanel, Breaker Sizes & Labels
70. Stairs & Rails
71. Fireplace or Stove, Clearance -Hearth
72. Elec. Outlets at Wood Panel, Int. & Ext.
73. Kit. Fixt. & Appliance; Ground -Air -Gap -Cooking Clearance
74. Elec. Outlets & Receptacles at Kit. Counter
75. Garage Fire Door; Swing -Landing -Closure
76. A.C. Duct in Garage -Damper
77. Wtr. Htr.; Vents -Clearance -Comb. Air Connector-P.R.V.
in Garage; Above Floor-Mech. Protection
78. Plb.; Elec. & Mech. Equip. Listed for Location
79. Elec. Receptacles in Garage (F.F.I.)-Romex Protection
80. Insulation -Foam -Looked in Attic
81. Guard Rails & Deck Construction -Post Caps
82. Fdn. VBents & Crawl Hole Door Drainage & Wood -Earth
Clearance Looked under Floor ❑ Yes
_
83. Following Instld./Drive 0 Yes D No/Walks 0 Yes O No/Planters D Yes O No
84. Stucco Brown -Finish
85. A.C. Unit Disconnect, Electrical -Plumbing
86. Vents Above Roof, Plbg-Appliance-Fireplace-Clearance to Openings
87. Water Well, Disconnect, Electrical, Plumbing
88. Exterior Elec. Trim, G.F.I. Receptacle -Underground
89. Ventilation Throughout House
90. Glass Protection
91. Corrections from Previous Inspections
92. Gas Test -Meters Tagged, Gas -Electric
93. Water & Sewer Connected -C/O to Grade -HD Approval
94. Energy Compliance Certificate -Other Certificates
95. Address Posted
96. Fire Sprinkler
Date
Card B-1 Date Card B-1
Date
Card B-1 Date Card B-1
Date
Card B-1 Date Card B-1
Comments at Final:
COUNTY OF BUTTE
BUILDING DIVISION
DEPARTMENT OF DEVELOPMENT SERVICES
411 Main Street • Chico, CA • (530) 891-2751
7 County Center Drive • Oroville, CA • (530) 538-7541
CORRECTION NOTICE
03 • �5
OWNER PERMIT NO.
A routine inspection indicates that the following violations of butte county Ordinances exist at the
above address and should be corrected. Please notice this office when correction of work is
completed. If you have any questions pertaining to this matter, or need additional explanation,
please contact this office immediately.
Date " Inspector
REV 10/92
Y
COUNTY OF BUTTE - DEPARTMENT OF DEVELOPMENT SERVICES - BUIL, ING DIVISION
7 County Center Drive • Oroville, California 95965 • Telephone (53 538-7541 PERMIT NO.
(Rev. 12/96) APPLICATION AND PERMIT 03-2497
ASSESSOR PARCEL NUMBER
024-150-081
ZONING
BUILDING PERMIT
KAWASPI,(I Jl`01-P
TELEPHONE
�I- -`
SQ. FT. OCC. BUILDING VALUATION
G9NT 799. 00
. OWNERS MAILING ADDRESS
680 LARKIN RD GRIDLEY 95948
COM pS NVE I T HONE ?
CJ
2 C� J 120.00
CONE ORS MAILING ADDRESS
CONSTRUCTION LENDER
Fireplace
LENDERS MAILING ADDRESS
Total Valuation 1 $ 5820.00
ARCHITECT OR ENGINEER
LICENSE NO.
Filing Fee
$ 20.00
Permit Fee
$ $ 00
ARCHITECT OR ENGINEERS MAILING ADDRESS
Plan Checking Fee
$
BUILDINGADDRCAO LARKIN RD GRIDLEY
Energy Plan Checking Fee
$
$
PERMIT FEE
$ 101.00
LOT NO.
SUBDN610N5 NAME
PARCEL MAP
PLUMBING PERMIT
Fling Fee 20.00
Each Trap
7.00
USEOFSTRUCTURE
SF Iti Duplex ❑ Mobilehome ❑ Other
SPECIFY
Solar or heat pump water heater
23.00
Water piping
15.00
Each gas water heater or vent
15.00
TYPE OF WORK
New ❑ Addition ❑ Remodel P Utilities ❑ Installation ❑ Other ❑
Describe Work: GO DRY RQT RETRe ;armgjTs (6)
Gas piping system 1 - 5 outlets
15.00
Building sewer
15.00
Mobile Home I S I G I W
@20.00
PERMIT FEE
$
ELECTRICAL PERMIT
Fling Fee 20.00
Main Service ppA OR LESS
23.00
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter
9 (commencing with Section 7000) of Division 3 of the Business and Professions Code,
and my license is in full force and effect.
License Class Lic. No.
OWNER -BUILDER DECLARATION
1 hereby affirm under penalty of perjury that I am exempt from the Contractors License
Law for the following reason:
❑ I, as owner of the property, or my employees with wages as their sole compensation,
will do the work, and the structure is not intended or offered for sale.
XI, as owner of the property, am exclusively contracting with licensed contractors
to construct the project.
❑ 1 am exempt under Sec. , Business and Professions Code for this
reason
WORKERS' COMPENSATION DECLARATION
1 hereby affirm under penalty of perjury one of the following declarations:
❑ 1 have and will maintain a certificate of consent to self -insure for workers'
compensation, as provided for by section 3700 of the Labor Code, for the
performance of the work for which this permit is issued.
❑ 1 have and will maintain workers' compensation insurance, as required by Section
3700 of the Labor Code, for the performance of work for which this permit is issued.
My workers' compensation insurance carrier and policy number are:
Carrier
Policy Number
(The above sections need not be completed if the permit is for work of a valuation
of one hundred dollars ($100) or less.)
I certify that in the performance of the work for which this permit is issued, I shall
not employ any person in any manner so as to become subject to workers'
compensation laws of California, and agree that if I should become subject to the
workers' compensation provisions of section 3700 of the Labor Code, I shall
forthwith comply with those provisions.
X ° Date �� /� D
Si tore of A p icant - Owner ❑ Contractor ❑ AgeM
An OSHA permit is required for excavations over 60" deep and demolition or constructio
of structures over 3 stories in height.
Main Service zoOA TO I000A
46.00
NEW CONST. DWELLING OCCUP.
OR ADDNS. ( a ACC. eLos.
SO
3.5¢x;
NEW CONST. MULTI -OUTLET
NON-RESID. BRANCH CIRCUITS @7.50
POWER APPARATUS
6 SINGLE OUTLET CIR.
Ex. Occup. OUTLET OR FIXTURESL 20
BAL @ I.50
FIXUTLEfSp 5.00
Ex. Occup. ORE�SIO °E
Temporary Service 23.00
Mobile Home Facilities 20.00
Misc. Wiring
23.00
PERMIT FEE $
MECHANICAL PERMIT
Fling Fee 20.00
Heating
Cooling
Hood 6.50
Ventilation
PERMIT FEE $
Mobile Home Installation Fee $
Energy Inspection Fee $
occ
CONST. TYPE
TOTAL FEE $ 101.00
HAz.
D. FEES IMP
I FLOOD
I CDF
PARCEL
I Po
I HD
SUE
11
This permit is hereby issued under
of the Butte County Code and/or
indi4dve hich fees have
By
PERMI XPIRESON
the applicable provisions
Resolutions to do work
been paid.
Date l
l .
I o
Dale
Receipt No. 385275$101.00
WHITE-D.D.S.-B.D. CANARY -ASSESSOR PINK -INSPECTOR GOLDENROD -APPLICANT